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Cornerstone Hospital of Southwest Louisiana Incorrectly Billed Medicare Inpatient Claims with Kwashiorkor

Cornerstone Hospital of Southwest Louisiana (the Hospital) in Sulphur, Louisiana, did not comply with Medicare requirements for billing Kwashiorkor on any of the 52 claims that we reviewed. The Hospital used diagnosis code 260 for Kwashiorkor but should have used codes for other forms of malnutrition. The 52 inpatient claims that were coded incorrectly resulted in overpayments of $343,000. Hospital officials believe that all claims identified by OIG were appropriately submitted for payment.

Filed under: Center for Medicare and Medicaid Services